Hypoparathyroidism is one of the complications of total thyroidectomy. It occurs not only due to accidental removal of the parathyroid glands, but also to devascularization of these glands. So preservation of the blood supply to parathyroid glands is essential by medial dissection of these glands which receive their blood supply from the posterolateral aspect. Also, the unfixed position of these glands carries a risk of their devascularization, but we must notice that the Superior Glands have a more or less fixed position at the Cricothyroid junction, so do your best to preserve their blood supply first.
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